HomeMy WebLinkAboutBuilding Permit Application ALL APPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED 60- S _
Date. Permit Number•
Building Permit Application
Planning and Development Services
Building and Code Regulation Division
2300 Virginia Avenue,Fort.Plerce A 34982
Phone: (772)462-1553 Fax: (772)462-1578 Commercial Residential X
PERMIT APPLICATION FOR, Mechanical
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Address: 500 ANN MARIE LN
Legal Description:
Property Tax ID#: 3426-664-0183-000-3 Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: _Right Side:'Left Side:.
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LIKE FOR LIKE 14 SEER 3 TON 10 KIN PACKAGE UNIT
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Additional work to bnerrormecl uncler til perm) –c ee 511 appy:
IZHVAC Gas Tank DGas Piping —Shutters Windows/Doors
11 Electric Plumbing O Sprinklers U Generator Roof
Total Sq. Ft of Construction: _._ S . Ft. of First Floor:
Cost of Construction: 3450.00 Utilities: Sewer Septic Building Height:
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Name LA Bl VITA CO-OP INC Name: JOHN V LANGEL
Address:8601 S FEDERAL HWY Company: SEACOAST A1C
City: PORI-SAINT LUCIE State:Fl- Address: 2601 INDUSTRIAL AVE 3
Zip Code: 34952 Fax; City: FORT PIERCE State:FL
Phone No.772-475-6542 Zip Code: 34946 Fax: 466-3053
E-Mail: Phone No. 772-4662400
Fill in fee simple Title Holder on next page(if different E-Mail: TLSEACOASTAIR@AOI_-COM
from the Owner listed above) State or County License: CACO16446
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
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DESIGNER/ENGINEER• Not Applicable 1 i " ' " 1 i;i :
�-.. pp MORTGAGE COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: State: City: State.
Zip: Phone. Zip: Phone'
FEE SIMPLE TITLE BOLDER: �Not Applicable BONDING COMPANY: _Not Applicable
Name: Name:
Address: Address:
City: City:
Zip: Phone: Zip: Phone:
I certify that no work or Installation has commenced prior to the issuance of a permit.
St.Lucie County makes no representation that Is granting a permit will authorize the permit holder to build the subject structure
which is in cont'lict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and 5t,Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,walls,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for .
improvements to yo r property.A tice of Commencement must be recorded and posted on the jobsite
before the first ins GtlOn. If you I end to obtain financing,consult with lender r an attorn y befor
commencing wor r recard1n r once of Commencement.
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_Signature of ner/Lessee/Agen Signature of Contr r/License W id
STATE OF ORIDA STATE QF FL IDA
COUNTY OF.ST cuciE COUNTY OF O FUME
The rgoing instru s c owledged re me The forgoing instrument was acknowledged before me
this day of 20 �.� this t6 day of MAY 20 _b
JOHN V LANor:06 JOHN V LANGEL
(Na e f perso ck ging y (Name of perso n ed
(Signatu Notary PLA ic.-State of Florida) (S gnat Notary Pu of Florida I
Personally Known x . OR Produced Identif Persona own x OR Produced identification
Type of identification Type of ---
,�` Y•* #FPi4807P ►* TRACY KAY!LAP1C1 L
Commission No. MY Ca % Commi s
'�;••.... C�XP{Fi$$ ug�iSt'�0,'�`018 � QN#J'Ei�@
?,,, cn gfrvioeacm EXPIASS August 30.2018
(4071 d7a0163 Ran
Devised 07/1512014
REVIEWS FRONT ZONING SUPERVISOR PLANS VEGETATION STA TURTLE MANGROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
INITIALS
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